All Things Mental

1.24.2018

My Thoughts and Comments on

This will go down as the largest systemic serial predator event in history, to date: bigger than Jerry Sandusky/Penn Stateevent - and that was horrific.

As I have worked with abuse victims for the past 37 years, the trail of damage in this case is made all the worse because of the vile, "look aways" that occurred for decades, also known as the "enablers."Chronic and repeat patterns of abuse (in this case, 265 young ladies have come forward, which probably puts Dr. Larry Nassar's number of victims closer to 500) indicate that a number of people and institutions, systems, failed these children. In other words, there was a multi-level system failure to protect, in fact, one could even argue, there was a promoting of sexual abuse and complicity that goes beyond simply putting blinders on and avoiding the obvious.

Whether we work in cubicles, executive environments, on group projects, or punch a clock in a factory, we know the twitchy patterns of our co-workers.

We know what they eat for lunch, what music they like, their favorite restaurant, and the alcohol they prefer. We can smell it. Our spidey senses are well-aware of miscreant behavior when we are close to it.For years, Dr. Larry Nassar was fed a human chain of young, healthy, ambitious, athletes (and let's not overlook the 37,000 child porn images and videos found on his computer).

Who, besides Nassar, is culpable here, within the USA Gymnastics team?Civil suits will rain down on the agency and changes will surely be implemented, as three directors have resigned this week, appropriately so. The most recent pressstates that the US Olympic Committee is asking that theentire US Gymnastics Board quit because of their negligence, lack of oversight, and the house of horrors that Nassar was permitted.Michigan State University President Lou Anna Simon(age 71, with an annual salary of $860,00), where Nassar kept his office and "treated" (his deviant grooming language) young patients, has resigned. N.C.A.A. has opened an investigation; Nassar was also the athletic doctor for MSU's members of the softball and cross country team.The USA Gymnastics Team has severed ties with the world-renowned Karolyi team, and their Texas training site, which additionally housed Nassar and afforded him privacy to carry out years of abuse.Yes, please!When an active duty service member takes his life, groups of people sit around a table and ask themselves: Where the fuck did we go wrong? We failed this young man!This psychological autopsy is meant to take stock, inventory, count the bean cans; forensically accounting for all choices, decisions, commitments, priorities, agency resolve.This is the post-mortem of the United States of America's Olympic hopefuls. We are poorer for this historical event.Work place ethics, a company conscience that holds leadership and financial profit within a reasonable balance, should be the cautionary tale.

Many clinicians like myself are often given the opportunity to come into a business and provide a mental health overview. Small mom-and-pop companies can be just as toxic as larger, remote businesses. The two-man flower stand is a work environment and the 100-employee company both have social responsibility to the care and well-being of the "little guy." Leadership. Leadership. Leadership.The smart money is on being pro-active and cleaning house. Intelligent business owners benefit from workplace wellness; protecting themselves prophylactically is the investment; allegation-proof.Corporate responsibility saves money and protects the longevity of business; just ask the WeinsteinCompany shareholders what they wish they had done differently.

1.14.2018

"I'm sorry for my kid. I want to apologize in advance for his rude behavior.

I'm sorry that he has chosen to wear his dirty pants again. He has clean clothes and we begged him to change. We throw out the bad stuff but still...

I'm sorry that my kid is so rude to you in line. We've repeated "Please" and "Thank you's" since he was born. We are civilized people and highly regard manners.

I'm sorry that he was defiant and contemptful to his terrific teachers this year. We raised him better than that.

Let me apologize in advance for how he is ignoring your sweet kids. I see the effort they are making; he is disengaged. I encourage him to socialize and make new friends.

Let me say now, I am so sorry for my child's behavior this season. Your players love you and the parents have been great. We just couldn't implement teachability, even with groundings, consequences, and taking the phone away.

I am sorry that my child didn't take you up on that great offer. I tried to force it but the motivation just wasn't there.

I apologize that my kid has blown such a great opportunity. It hurts my heart.

I cannot believe that my child would behave this way. I don't understand it. We are good, hard working "normal" people. My other kids are not this way.

I am heart broken. What can I do? This is painful beyond belief."says every parent at some point

The hardest job in the world...being a parent.

12.20.2017

I was at a Christmas party last weekend, and enjoyed a terrific conversation with someone I don’t know very well; a lovely older woman.

She told me that due to a recent difficult family circumstance she has decided "not to do Christmas this year."

It was painful for her to get to this emotional resignation, the deep acceptance, that she just didn’t have it in her this peppy holiday season to provide food, purchase gifts, socialize, mail Christmas cards, cook, or decorate.

She said, "I have given myself permission."

It was such a graceful and self compassionate (she was not boasting in a selfish manner, and I could still hear some longing) but it was mature and wise and intelligent.

Three points for the holiday that have been made clear to me recently, and you certainly don’t need my permission but, just in case...

1) December 25th is just another 24 hour day. Of course, it may have significant religious or spiritual meaning for you but we still have 364 other days of the year to celebrate our faith.

2) If you were invited to a gathering, you can simply say "No, thank you for thinking of me." And if you choose to say yes, you don’t need to say,"May I bring something?" I don’t know about you but when I bring food or gifts there is always an over-abundance of food these days. Sometimes it’s smarter to show up empty-handed (I learned to say this after I had my second baby: "May I come empty-handed?" Otherwise, I began to dread the social commitment, and would cancel altogether).

3) And finally, may be the greatest act of celebrating the end of the year is maintaining a small footprint, giving yourself a present, laying in the sun for 20 minutes, ordering a fancy meal to go and taking it to the beach, planting some flowers, writing a silly poem to an old friend, giving the dog a bath and a pretty red bow.

Honestly, if that’s all you do on December 25th, or December 31st, or January 1st, those are extraordinary, lovely, meaningful, gestures. That's enough.

My youngest son and the crazy man, 2004

12.02.2017

Common Myths About
Therapy

By Christina Neumeyer

Therapy takes years: I will lie
down on the couch and we’ll talk about my mother – a lot. This
is a hold-over from the psychoanalytic days of Freud and often satirized in
Woody Allen movies. I don’t know any therapists that have clients lie down on a
couch. Most clients want to get in and out of therapy as quickly as possible.
Having said that, earlier events in one’s life often have meaning - maybe not
all of the meaning - to the current dilemma at hand; how we have been shaped by
our experiences and how we live and breathe in the world. Therapy can always
begin with the here and now.

A counselor can talk sense into my
son/spouse/mother/son-in-law. Bringing the substance
abusing adult son into therapy is a worthy task, but magic isn’t sold there. The
most painful situations, those that heavily weigh one down with sadness and
grief, are those hours spent with the loved ones of someone who is refusing
help. We help the helpers and always
remember that therapists are one humble instrument in the orchestra of healthy
living.

Counseling is an intense
self-analyzing, navel-contemplating process. Self-reflection
is what separates lizards from humans; we are designed to ponder our meaning on
planet earth, but, it is not an exercise without a goal in mind. Efficient
therapy combines action steps (behavioral changes), with verbal processing
(“How did it go?”), sideline cheerleading (“I remember how difficult that might
have been six months ago. Great job!”), and the occasional different
perspective offered from an unbiased party.

I’ve tried it before. It doesn’t work.
This may be the hardest distrust to overcome, but, if at first you don’t
succeed, try and try again. With any event, whether it’s finding a good
handyman or hiring a math tutor for your kid, coming to believe that help is
available becomes a critical leap of faith. If my neighbor has a good mechanic,
and I need a mechanic, I will likely begin believing that Bob the trusty
mechanic can fix my car problem. In much the same way, if I can emotionally
somersault into “I think there are people who understand my condition,” I am
veering towards improvement. For this reason, once the phone call is made,
recovery often begins in that moment. Therapeutic techniques matter, but the
relationship between client and therapist equally contribute to positive
outcomes.

A counselor will only tell me to
find my passion/quit my job/walk away from my relationship.
The sixties heyday of me-me-me, when therapy developed a reputation for not taking
anyone else’s feelings into consideration, are over. Individual needs are best
served within context to what we know brings us meaning and purpose. Freedom of
choice is soundly measured against decisions we can live with; abandoning our
families and emotionally cutting off from those things that challenge us do not
produce peace of mind. Human beings are social animals that seem to do well
when paired up, enjoying warmth and well regard from others. Any intelligent clinician
will be helpful only when taking into consideration the ecosystem that the
client inhabits - this is of primary concern.

Only people with severe problems need
to see a counselor. I don’t know how to defend this misbelief,
and even my dearest friends will comment along these lines. To them I say, all
great leaders had counsel to sort through what was troublesome; even the
strongest knife cannot sharpen itself. Counseling helps the 84-year old widow
who lost her spouse of 62 years, with wonderful but busy grown kids that forget
to call enough. She has led a great life, but has a story to tell; her siblings
have passed and her life-long friend has beginnings stages of dementia. Gracefully
accepting of life’s short road, we might review old photos together and discuss
the many chapters she experienced. How wonderful! Or, the young couple
navigating another deployment; a young mom with a new baby and no familial
support nearby. The 19-year old college student that was assaulted; or the executive
couple that has grieved four miscarriages, now making a decision on how to best
move forward. Normal people fighting a good fight benefit from outside
professional help from time to time. Psychotherapy is a healing art, and a lot
like midwifery; silent observers, willing the very best outcome to present
itself.

Therapy is all about feelings.
Well-balanced people are able to identify their inner emotional landscape (“name
it to tame it”), and language skills paired with an emotion is the most direct
way to get one’s needs met (“I feel so appreciated when you bring me flowers at
the end of the long week. I feel loved and remembered.”). While we often
encourage folks to “get in touch with their feelings,” (the opposite of expression is depression) that is simply one part
of self-understanding and personal growth. With solid research showing us that
beliefs matter too, there can be a fair deal struck between how we feel and how
we think (they are not the same). Personal insight is critical to optimal
mental health. Tolerating gentle prodding and curiosity of one’s internal world
is a sign of a healthy system. In fact, present-day therapy is a good fit for
the thinking person. With the popularity of best-selling authors Daniel Pink,
Daniel Khaneman, and Malcolm Gladwell, and advances in sports psychology, there
is a blossoming marriage between corporate leadership psychology and interpersonal
intelligence that should earn respect from any project manager or critical
thinker. We can’t afford counseling.
I know it may seems as if all roads begin and end with the mighty dollar, but I
remain convinced that there is both low-cost counseling as well as free
counseling in most areas. In my neck of the woods, several non-denominational churches
offer free counseling, without being a church member. Often times the church
has partnered with well-seasoned agencies and therapists (NAMI, for example) to
offer free support groups. A second low-cost option is utilizing registered
interns - they are trained but not yet fully licensed (even to be an intern,
one has several hundred hours under his/her belt and a graduate degree). Interns
are overseen by supervisors within an interdisciplinary format (psychiatrists,
psychologists, social workers) collectively participating in the case
management. This is good news for those wanting to deal with big problems at an
affordable cost. An intern opening up their first private practice often
provides 1970’s rates as their practice is building. The third option available
are low-fee clinics who are granted funding for affordable care and counseling,
with sessions as low as $15 per session or as much as $50.00. Many local
low-cost medical clinics have incorporated an integrative behavioral health
section in their effort to wholly meet the needs of the community. I have
interfaced with a few of these and they have been great. Never give up on
striving for a healthy life. Be persistent.

11.22.2017

1) The
therapist is a referee, with the task of weighing in on
who is right and who is wrong; the clinicians are there to take sides. Weigh
in, rip me a new one and point out my numerous shortcomings. False. In reality, therapists rarely
“offer advice” and there is rarely a right side and a wrong side, unlike Judge
Judy. Most of life’s difficult is in the gray area. Between adolescent and
parent, each side usually has valid points, between two partners, each has a
position and unique experiences that are worth acknowledging. With Dr. Phil and other
popular tv shows that introduce the idea of “counseling,” it’s understandable
how lay culture has Jerry Springered the view of the counseling office; what
is intended to be a safe and sacred space for sincere pain and recovery to occur.2) Counseling
cannot possibly help. In fact, counseling may make things worse.
It is often the case that bringing issues into the light may feel worse in the
short term, with long-term pay off. If anxiety and panic attacks have shrunk my
world, and now I am exposing myself to those triggers (crowds, stores,
driving), necessary steps to recovery will be provocative. Taking stock of our
lives, reviewing past events, is often walking into the lion’s den, and
avoidance has kept the angst to a manageable level but the cost has been great.
With guidance and a collaborative treatment plan, the short-term distress will
diminish with great rewards over time. Therapy absolutely helps. People who are
motivated to learn about who and what they are make the most satisfied –and
enjoyable! – clients.

3) Female
therapists side with women. False. Males don’t stand a chance
in the therapeutic environment. False. Tongue lashings and confrontations
ahead. False. Effective treatment does not include male bashing. I can make a
strong argument that a good therapist is hyper-curious: why else would we ask a
million questions? In other words, inquiry about your experience in this
challenging world is the trailhead of being helpful to you. Counseling should
not be aggressive, harsh, or disrespectful.Counselors should be quick to admit where they are wrong, may be off in
their perception, or are not adequately grasping the problem at hand. After
all, any business model that disrespects a paying customer is a short-lived
endeavor. Therapist behaviors that make everyone present feel heard and
respected are communicated via expressions, body posture, vocal tone, and
verbal reflections that indicate comprehension (“Am I hearing you correctly?”)
as well as therapist’s own self-awareness.4) Therapists
are anti-religious and will not honor our values.
A good clinician willwork in alignment
with your values, towards your goals, in this highly collaborative treatment
process. Period. It is irrelevant what customs and values the clinician holds;
in fact, anything else is poor patient care. Busy clinicians work
with a wide range of clients, ages, stages, cultures, and communities: that is
what makes our job so fabulous. Standard business practices assumes cultural
and religious humility with a position of counselor equality; not
superiority. 5) We
can’t afford counseling. Divorce costs more. Moving out and
establishing a new home costs more. Breaking up families and sharing custody of
the children costs more. There is low-cost counseling available. Additionally,
there are weekend boot camps, couple’s day retreats, and several other options
(i.e. Gottman Apps, Marriage 365) that can educate a couple on how to better
get along, communicate, and re-connect. Most couples want a new marriage with
the same person and statistics indicate that 50% of divorced couples regretted
their decision to leave the marriage. Never underestimate how difficult divorce
will be.

11.14.2017

11.02.2017

Holiday Volunteer Opportunity

If
you are looking to combine the exciting experience of travel with that
wonderful feeling of purpose, this group may be perfect for you.

My lovely neighbor recently lost her adult son, and, as part of her
grieving process, she chose to fill her cup through volunteerism.
Throwing a garage sale to supplement the cost of airfare, she spent 10
days on Matangi Island, Fiji on a helping mission.
No medical experience needed; just willing hands and an open-mind. http://www.lolomafoundation.org/

10.27.2017

2018. Start the New Year off with a great class. Dedicate yourself to optimal mental health. Here is one suggestion; anything offered by UCSD Center for Mindfulness (suggest the self-compassion or stress reduction class). Or perhaps the highly recommended workshops coming up soon withKristin Neff.

National Alliance on Mental Illness (NAMI) offers a free 12-week class for family members living with a mentally ill loved one.

North Coast Calvary Chapel will be hosting NAMI – Family to Family Education Program.

This is a free, 12-week course for families and friends of adults
living with schizophrenia, bipolar disorder, major depression, anxiety
disorders and borderline personality disorder. Course participants gain
vital information, insight and understanding of their loved one that
many describe as life-changing. Registration is required and limited to 25 participants. To
register or for more information, contact the office at
info@naminorthcoastal.org or 760-722-3754

Here is a powerful poem I heard read at a funeral recently:

The Invitation

It doesn't interest me what you do for a living. I want to know what you ache for and if you dare to dream of meeting your heart's longing.It doesn't interest me how old you are. I want to know if you will risk looking like a fool for love, for your dream, for the adventure of being alive.It doesn't interest me what planets are squaring your moon.I want to know if you have touched the centre of your own sorrow, if you have been opened by life's betrayals or have become shrivelled and closed from fear of further pain.I want to know if you can sit with pain, mine or your own, without moving to hide it, or fade it, or fix it.I want to know if you can be with joy, mine or your own; if you can dance with wildness and let the ecstasy fill you to the tips of your fingers and toes without cautioning us to be careful, be realistic, remember the limitations of being human.It doesn't interest me if the story you are telling me is trueI want to know if you can disappoint another to be true to yourself. If you can bear the accusation of betrayal and not betray your own soul.If you can be faithless and therefore trustworthy.I want to know if you can see Beauty even when it is not pretty every day. And if you can source your own life from its presence.I want to know if you can live with failure, yours and mine, and still stand at the edge of the lake and shout to the silver of the full moon, 'Yes.'It doesn't interest me to know where you live or how much money you have.I want to know if you can get up after the night of grief and despair, weary and bruised to the bone and do what needs to be done to feed the children.It doesn't interest me who you know or how you came to be here.I want to know if you will stand in the centre of the fire with me and not shrink back.It doesn't interest me where or what or with whom you have studied.I want to know what sustains you from the inside when all else falls away.I want to know if you can be alone with yourself and if you truly like the company you keep in the empty moments.by Oriah Mountain Dreamer